New laparoscopic sterilization with exteriorization of tubes (cauterization, ligation): a preliminary report

The fallopian tube's remarkable mobility and inherent length makes possible its exteriorization from the abdominal cavity to perform any kind of tubal sterilization. We offer a new laparoscopic technique utilizing (1) exteriorization of the tube and the performance of either (a) tubal ligation (Pomeroy technique); or (b) unipolar cauterization, or (2) intraabdominal in-sleeve cauterization in case of failure to exteriorize the tube. Our approach, on the one hand, was to avoid laparotomy but still preserve the advantages of tubal ligation, and on the other hand, to avoid possible bowel burn but still retain the beneficiary effect of electrical cauterization. To accomplish this, a simple second puncture uninsulated trocar-sleeve and grasping forceps were designed. With this technique, 325 patients have had voluntary interval sterilization at Olive View Medical Center-UCLA Campus (1977-1980). No bowel burn or pregnancies have occurred. No laparotomies have been necessary. Complications were minor and compared favorably with those cases in which other techniques were used.